Category Archives: substance use disorders

10 Rules for recovery after an affair.

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Emotional Affair

Recovery after an affair.

The common perception is that once the affair is discovered the couple is headed for divorce. The truth is that up to 70% of married couples stay together, for a variety of reasons, after they discover that partner was having an affair.

Among those who do divorce, many will later regret making that first impulsive decision.

Your family and friends may be telling you to kick him, or increasingly her, to the curb. But should you call it quits? What does it take to recover from an affair? How can marriage counseling play a role in mending the pain?

1. Don’t make sudden decisions when you discover an affair.

Give both of you time to think it through. You have a lot of time and emotions invested in this relationship. You owe it to yourself to see if it can be repaired before you junk it.

2. Both of you need to process how the affair affected you.

Both partners in the relationship may need therapy to work through their feelings about the affair, their relationship, and how it reached this point.

Therapists recommend that the non-affair partner write a letter to the affair partner telling them how they feel and how this has affected them. This is the kind of letter you need to write but do not need to send. Process these feelings first in your own therapy. Eventually, you may be able to read this to your relationship partner and help them to understand how this has affected you.

3. You need to create empathy for the non-affair partner.

Many people who have had affairs have very little understanding of how this has affected their partner. They will say in counseling that they have ended the relationship and that should solve the problems. Having them listen to the non-affair partner talk about how they were hurt by the affair and what feelings this created in that person can increase empathy and understanding.

4. Avoid staying together after the affair and ending up living two separate lives.

Some couples arrive at this point as a result of unspoken feelings. They will stay together for the children, for the economic needs, or because of the problems of splitting assets. What they don’t plan on is having an emotionally close relationship ever again. Most of these efforts fail as the two people involve find that they are living a life devoid of love and affection.

Even if the couple plans to try to make this relationship work, avoiding having those tough talks about their plans goals and future may result in a relationship that feels like to unrelated people living in the same house.

5. Rebuilding trust after an affair is a long hard process.

The most devastating part of finding out your partner had an affair is the feeling of betrayal of your trust. It takes a long time and lots of effort to rebuild that trust. You need to let each other into both your lives and make sure neither is hiding anything. Do not tell your partner you are going to get gas for the car and then turn up several hours later with leftover takeout food. If you plan on several stops tell your partner if plans change, call them and let them know, or stick to the plan and make a second trip some other time.

6. Do not use counseling or therapy as a way to get even with your partner.

Trying to use marriage counseling as a way to get even with the affair partner makes things worse. No amount of beating them up will erase what happened and it will result in fresh wounds that may never heal.

7. Give the non-affair partner all the information they need but no more.

Many partners want to know every detail, what did you two do in and out of bed. It is important to stop keeping secrets but beware of giving more details that requested. Non-affair partners can suffer from symptoms similar to Post Traumatic Stress Disorder. After hearing about sexual activity between the partner and the affair partner the non-affair partner can experience intrusive thoughts. They may imagine graphic images of their partner engaged in sexual activity with another person.

8. Make post affair counseling a repair effort.

Give the partner that had the affair a chance to show their intentions. Do they do small things to make it right but quickly slip back into old behaviors? Let them know that you hope for and expect the best but they will need to prove their desire to change and make it right by making visible changes in their behavior.

9. Get extra honest with each other to rebuild trust.

Affairs are about the fights you never had. If there are problems in the relationship talk them through. Work on expressing your feelings, being careful to ask to have your needs met rather than run your partner down. “I feel disrespect when you do not help clean up after dinner.” Not “You are such a pig!” You never clean up after yourself!”

One key characteristic of affairs is the need to keep secrets. The non-affair partner sometimes feels then may have contributed to the affair by not asking what the other person was doing and feeling. Some people who have had affairs tell me that they felt they had a sort of permission to have the affair a “don’t ask don’t tell” code.

Couples may need to have a lot of those talks about sex and relationships they did not have before they entered this relationship. Women frequently have a different definition of an affair than a man will. She thinks that flirting and emotional closeness with another woman is cheating. He may think that anything short of intercourse is OK. That attitude and some alcohol have led to a lot of one night stands.

10. Avoid the problematic use of drugs and alcohol.

Drugs and alcohol lower inhibitions. People with an untreated substance use disorder are at increased risk to engage in affair behavior. Drinking and using places encourage sexual activity. People who abuse alcohol and drugs may accept those kinds of behavior as a part of the “Partying” lifestyle.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Tobacco is the ticket to mental illness and addiction

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Smoking cigarettes.
Photo courtesy of Pixabay.com

Tobacco and Mental Illness.

Early Cigarette smoking is strongly linked to developing a mental illness or an addiction

The younger you start smoking the riskier it is. In our efforts to teach kids about drugs and addiction we have been neglecting to focus on the one drug that seems to be the ticket to later-life mental illness and addiction.

That drug is nicotine.

Most young people with a drug or alcohol problem began to smoke between the ages of 11 and 13. Early use of alcohol is also a factor. For now, let’s talk about the impact of smoking cigarettes on teen’s development of a mental illness or an addiction.

Among adult smokers, over 80% began smoking in the early teen years.

What has gone unnoticed for so long is the connection between this early smoking, the development of addiction to other drugs, and the development of a mental illness.

Fortuna Et al. reported on a study of adolescents in a residential substance abuse treatment program. You need to have developed a serious problem to get into residential treatment in most places these days. What they found was disturbing.

An occasional smoker, those “social” smokers, can develop a dependency on Nicotine in as little as 4 weeks. Kinney reported in a drug treatment book that after smoking just one cigarette, once they light up that second time, a young person has an 85 % chance of becoming a daily smoker. That is an extremely addictive substance.

Among teen smokers in residential substance abuse treatment, the problems with mental illness were significant. Those with depression and anxiety, both common across the lifespan, they were twice as likely to develop nicotine dependence as those without a mental illness.

People with Bipolar Disorder and or Schizophrenia are three times more likely to be nicotine dependent. Even the rates of smoking among those with ADHD are reported as significantly higher than those with no mental illness diagnosis.

Being the victim of, or being exposed to trauma, domestic violence or other abuse and neglect also correlate with an increase in smoking and nicotine dependency.

It is worth noting that from the design of these studies we can’t be sure of the exact nature of the connection. Does smoking increase the risk of developing a mental illness? It looks likely. It also looks likely that those with a preexisting mental illness are more likely to take up smoking. Either way teen smoking is a whole lot more troubling than anyone recognized in the past.

What Fortune et al. did conclude in their study was that a teen’s cigarette smoking significantly increased the risk of them developing a serious drug or alcohol addiction. They also report that those with co-occurring disorders, addiction, and a mental illness are much more likely to become nicotine dependent if they start smoking.

In this study, the only drug that teens had used first more often than smoking tobacco was smoking marijuana. We have known that route of administration significantly impacts the way the drug affects a user. It seems to me that any drug that is smoked can lead to dependency faster than other routes of administration. Even so, the conclusion that more teens with co-occurring disorders began by smoking marijuana is a concern.

Alcohol use was a close third in the drug that teens who later developed an addiction had used first. This suggests that parent use, societal approval, and ready availability are all factors in teen’s first picking up a drug and then in progressing to a more serious substance use disorder.

Most of this kind of research looks at those who develop problems and then looks back at what route the followed to get to addiction. We can’t be sure what percentage of teens that smoke cigarettes, do marijuana, or drink alcohol will go on to develop a substance use disorder or a mental illness. Still, it seems clear that those who do develop an addiction or a mental illness, most of them started abusing the readily available substance at an early age.

In studies of teens in drug treatment, Fortune et. al especially notes this, smoking is so common, almost every teen is a smoker, it is hard to see the differences between the smokers and the nonsmokers.

Lawrence et. al, looked at the connection between smoking and mental illness in a large sample of youth, not in treatment. Their conclusions were similar. Teens with a mental illness were far more likely to start smoking at an early age, smoke on an everyday basis, and be heavy smokers. They clearly identified a link between teens who smoke and mental illness.

It is important that in addressing teen mental health issues and substance abuse issues we not overlook the role of nicotine and early smoking. We also need to keep an eye out for the emergence of increased marijuana use as the first indicator of a teen mental health issue.

Other research and treatment protocols have looked at the need for a different form of treatment for those whose primary drug of choice was Marijuana and who had self-reported this as being a problem. For more on drug-specific treatment of Marijuana look at the SAMHSA publication on Brief Counseling for Marijuana Dependency (BCMD.) This publication is free.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Does smoking cause mental illness?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Does smoking cause mental illness?
Photo courtesy of Pixabay.com

The evidence is starting to pile up that smoking may be a cause of some mental illnesses.

We have known for some time now that the mentally ill were heavy smokers. Those with psychosis, schizophrenia, in particular, are frequently two pack a day or more smokers.

We also have seen studies that report from 44% to over 50% of the cigarettes consumed in America are consumed by those with a mental, emotional, or behavioral disorder. Alcoholics and Drug Addicts are frequently heavy smokers.

Fully one in three adult smokers has some form of mental illness.

What most researchers have been reluctant to conclude is that smoking may be the cause of some of these mental illnesses. That is beginning to change.

One problem with the past studies has been the way the samples were drawn. A survey of the population can tell you how many people have a mental illness and how many smoked, but not which caused which or were they both caused by some third factor like poverty or trauma.

One particularly convincing study was done in Norway (Petersen et al. 2008.) They have good data on who was treated for what and why. This study was able to follow a large sample of youth beginning at age 13 and lasting 13 years until they were 27. They looked at who smoked at age 13, when they started, and the results. They were also able to follow the person’s health and mental health treatment.

This longitudinal study allowed them to compare those who had a mental illness at age 13 with those who did not and those who smoked at age 13 with those who did not. Their data tells us that those with an early onset of mental illness were at high risk to become daily smokers with a nicotine dependency.

What was more startling was that those who had no mental health diagnosis at age 13 and smoked were more likely to develop a mental illness. Smoking appears to have preceded the development of the mental illness. Even more, evidence that a mental health issue is caused by not is the cause of, smoking was found in the effects of levels of nicotine dependency.

Those youth who were heavy smokers (nicotine-dependent) developed more mental health problems regardless of the age at which they first started smoking. Someone who became a heavy smoker at age 20 with no history of mental illness was at high risk to have a mental illness at age 27.

Further evidence of the connection between smoking tobacco and mental illness comes from a study from South Australia (Bowden et al., 2001) which found that the more severe the level of mental illness the more likely the person was to smoke. The most seriously mentally ill had a smoking rate in excess of 51%.

This leads to the inescapable conclusion that smoking increases the risk of developing a mental illness in addition to the physical ones we already knew about.

How might smoking be increasing these risks?

One way smoking may increase the risk of developing a mental illness is Nicotine’s effect on the serotonin regulation in the brain. Nicotine impairs the serotonin function of the brain. Low serotonin has been postulated to be a major factor in Major Depressive Disorder. Selective Serotonin Reuptake Inhibitors (SSRI’s) that slow the breakdown of Serotonin and thereby increase the levels of serotonin in the brain are commonly used to treat depression. One antidepressant is also currently being marketed to help people stop smoking.

But there is more.

Smoking reduces the levels of oxygen in the bloodstream and the brain. This reduced oxygen is a factor in the presence of chronic pain and now appears to also be a factor in increasing depression and anxiety.

Social factors may also account for some of the differences in depression in non-smokers versus smokers. With societies shift to preferring nonsmokers, there are restrictions on smoking in public places. Smokers are finding it harder to get jobs and to be able to get off duty during the workday to smoke.

Not having a job, having few social friends, and being socially undesirable all add to the reasons a smoker is more likely to be depressed than a nonsmoker.

In future posts, we will explore the connection between smoking and specific mental illnesses and look at how and when you should quit if you want to maximize your mental wellness.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

5 ways the Internet may destroy your relationship

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Computer

Internet usage.
Photo courtesy of Pixabay.com

Signs internet usage may destroy your relationship.

The internet has changed how we all live our lives for good and bad. It can help you find information, directions, and possibilities. Singles can use online dating sites to find dates or even long-term partners. It can create a lot of happiness.

Internet usage can also destroy relationships. Here are five ways your or your partner’s internet usage could be jeopardizing your relationship.  These are not discreet problems. A particular person or couple may be affected by one or several of these problems and sometimes one problem can morph into another.

1. Cyber-flirting and emotional affairs.

Talking inside games or chat rooms can start off innocently enough. In the relatively anonymous environment, it is easy to flirt, make sexual comments that would never be allowed in real life. You think you are getting to really know the other person at a very rapid pace.

In the online world, you do not have to see the person when they are tired or cranky. You can put only your best, often fictitious, self forward.

People will disclose to an anonymous avatar, feelings that they have been unable to express to their life partner. The feeling of being understood and cared for can be created quickly and look more real than it is.

More than one person has fallen in love with someone on the internet only to find out that this person never existed or was very different from the way they represented themselves.

Emotional affairs involve a giving of feelings and self to a stranger that should have been saved for the partner. People will tell their secrets and their partner’s confidences to a comparative stranger often with disastrous results.

Some partners of people having emotional cyber affairs describe them as even more painful and damaging than a real-life one night stand. You can alibi the one time sex, alcohol, being out-of-town, overcome by a momentary weakness. But the time spent in romancing a cyber affair partner and the keeping of the secrets this entails is a more severe breach of the trust that a relationship partner can excuse.

2. Cybersex.

Cyber-flirting can easily expand to cybersex. IM allows a conversation that can quickly escalate in emotional intensity. People can live out their sexual fantasies; describe desired sex acts that they feel uncomfortable describing to a real live partner.

People become their alter egos; the unemployed man becomes a jet-setting playboy. The middle-aged mother of 6 becomes a hot twenty-something model and this fictional couple describes all the emotional and sexual acts they wish they could do. People may fanaticize about behaviors that given the chance to act out in real life they would decline.

This cyber flirting or cybersex can involve masturbation and become a substitute for real-life sexual activities.

These cybersex activities may include sexting and incurring time spent thinking about and participating in fantasy sexual activities.

3. Internet created sexual affairs.

Cyber-flirting and cybersex may move into the real world. Online infidelity often begins with looking for an affair.

Adult dating sites and the relative anonymity of chat rooms have made it easier than ever before for people to find other people for sexual relationships. The relative anonymity of the internet encourages people to talk more openly and that feeling of intimacy can develop much more rapidly.

These internet arraigned sexual liaisons may go on for years, one partner after another.

Often these internet facilitated affairs are discovered accidentally. When they are discovered there can be an explosive reaction from the relationship partner.  This sudden disclosure of infidelity can result in separations and divorce.

Even when the affair goes undiscovered or if the couple decides to stay together after the disclosure of the affair, this event can permanently damage or alter the relationship.

Developing an online relationship requires dishonesty and keeping secrets. To facilitate this behavior the partner having the affair needs to become more secretive and dishonest. The relationship couple moves farther apart emotionally. A distance between the couple may be created that can never be bridged.

4. Internet pornography.

The internet provides a ready access to pornography. There are graphic images of all manner of sexual activity. Some of these activities may be illegal, child porn for example.

Porn can also be computer generated with no real people involved in the activities the viewer sees. This material can quickly create a distorted view of sexual reality. Not many people have near-perfect bodies. Even the most sexually adventurous person can’t engage in all the activities that are portrayed on the porn site.

A real live partner pales in comparison to the images on the web.

Viewing graphic sexual materials is very emotionally exciting and the occasional view can quickly escalate to an addiction. The magnitude and destructive properties of porn addiction have only recently been recognized and the harm porn can cause has been underestimated.

This should not be taken to mean that we should return to the Victorian era when no bare skin showed and sex was a taboo subject. Some sexual behavior and arousal are normal and healthy. Researchers have made the case that some viewing of sexual materials can inspire a couple to be more adventuress.

What is a problem is when this becomes a habit that races out of control. Sexual arousal is a very powerful force and can quickly lead to some form of sexual addiction.

5. Internet addiction.

In this internet activity, the sexual component is absent or minor. One member of a relationship becomes more and more involved in their online activities to the point of failing to meet relationship responsibilities.

They can play online games and forget to go to bed with their partner. They may stay up later and later to play online games or other activities.

Eventually, this online need overtakes their real responsibilities. People with an internet addiction may miss work or come in late from being up all night gaming.

They may experience real emotional withdrawal reactions, anger, and anxiety when they are unable to participate in their customary on-line activity.

If you or your partner has developed any of these internet issues your relationship does not have to end. Marriage or relationship counseling can help. A relationship may become stronger and better as a result of the steps you take to repair these problems.

In future posts, I plan to explore internet addictions, affairs, and other relationship issues in more detail. Hope you all stay tuned and follow counselorssoapbox.com

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

How are children’s substance abuse problems different from adult addiction?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

sign

No Drugs.
Photo courtesy of Pixabay.com

There are some differences between the substance abuse issues in children from those in adults, but they may be less than we used to think.

There are a lot of people who continue to think of substance abuse, addiction in particular, as an adult disease. That would be way wrong.

Most adults with a substance use disorder began their use at a young age. Seventy-five percent of all disorders, mental health, and substance use, begin before age 24. Half start before age 14.

Kids are getting into drugs and alcohol abuse earlier than most adults realize.

Larger treatment facilities will tell you about children as young as 5 that already are developing signs of alcoholism. Children frequently report that their drug use began as early as age 8.

That’s right folks, as soon as the end of the third grade we are already able to identify children at risk to develop an addiction, going to prison, or both.

Are there “Gateway drugs?”

There used to be much discussion of so-called “gateway drugs.” The idea was that up till you tried the gateway drug you were not at risk of becoming addicted. Once you take the gateway drug you are on the path to addiction. The drug that got blamed the most as a “gateway drug” was marijuana. While I think letting your third or fourth grader smoke some of your “medical marijuana” is a way bad idea, it has turned out that for most adult addicts that was not the gateway drug.

One reason that marijuana was implicated was that it was illegal. That meant that to procure marijuana in the first place you had to be breaking the law. Someone who was selling marijuana illegally and risking jail might also be selling other “harder” drugs. Breaking society’s rules on substance use is a bad direction to start out on, but there is more to the story than that.

For most children, the gateway drugs have been cigarettes and alcohol. Consider the cost to society of a child who starts smoking at an early age. There is good evidence to show that after trying that first cigarette if the child lights up a second one they are going to be smokers for life.

Look around any homeless encampment, any old-time A.A. or N.A. meeting or the public hospital emergency room and you will find a lot of smokers. Nicotine has been reported as more addicting than heroin. I have heard people in recovery from drug addiction say that it was harder for many of them to kick cigarettes than to kick the heroin.

Alcohol is also a severe problem for children.

The younger they start drinking the larger the risk. Some people have argued that there are places in Europe where children begin drinking at a young age and do not develop any higher rate of alcoholism than we do with a legal drinking age of 21. The biggest difference is that in those cultures children learn to drink a small amount with meals and as part of a social occasion.

Here in America, the tradition is that when you drink – drink all you can. These drinking occasions are times when a bunch of people are out to “party” and alcohol is a large part of that. The result is that children, teens, in particular, learn to drink heavily and to drink to get drunk. You do not take your grandparents to the party with you.

Drinking to get drunk, binge drinking is, of course, the riskiest way to drink.

Younger substance abusers go for cheap or easy to get substances. They are more likely to sniff paint or glue. They are also less likely to understand how risky a substance is; hence they go for synthetic drugs because they can get them without breaking a law. What they miss is that these drugs are “not for human consumption” for good reason. Some of these synthetic drugs can cause permanent brain damage.

Back to that gateway argument. It appears that it is not the fact that a drug is illegal, as in the status of marijuana in the past, but the fact that it is “illicit” that the child is sneaking to do something they are not supposed to do, that predisposes them to greater risks down the road.

One thing we miss is the relationship between substance abuse and crime. This is not solely the rule for adults. Children of any age who drink or do other drugs are more likely to do other crimes, behave in anti-social ways, and get into trouble.

One report said that on the order of 80% of all those in prison here in California were drunk or high in the 24 hours before they did their crime.

There is no doubt that being under the influence disinhibits you. Drug use also means you need money and that may lead children to do crimes to pay for their drug and alcohol activities. It is hard to keep asking mom for drug money unless she is also in the drug game.

Drinking and drug use may look different in youngsters than in their older compatriots but addiction and alcoholism start in the young and just keep getting worse.

As a colleague of mine keeps reminding us – any drug use by an eight-year-old is a problem.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

First night of Drug and Alcohol Classes

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By David Joel Miller.

Drugs.

Do drugs cause mania.
Photo courtesy of Pixabay.

Tonight is the first night of classes here at FCC.

One activity in my busy schedule that I thoroughly enjoy is the opportunity to teach Substance Abuse Counseling classes at Fresno City College.

The program here is accredited by the California Association of Drug and Alcohol Educators (CAADE) and leads students towards becoming registered and then certified drug and alcohol counselors.

The program includes 36-semester units of classes in Drug and Alcohol use disorders, recovery, and the work of counselors and social workers. A few students from the 4-year college show up in these classes because this program contains more information about Substance Use Disorders than most Masters or Ph.D. programs.

We see students in this class who want to be drug and alcohol counselors. There are often also social work majors, nursing students, criminal justice majors, and a smattering of people who are in early recovery and know they need more information on Substance Use Disorders to be able to decide what career is right for them.

All these majors are welcome. I try to emphasize that first night that no matter where they work there is a strong possibility that they will encounter people with substance use disorders. They will also if they see substance abusers see mixed in with those clients a lot of people who have emotional or mental health issues.

For those of you, who are not able to take classes of this nature, consider some reading on the topic of substance use disorders, (The A.A. big book is a good place to start.) Also, consider taking a Mental Health First Aid (MHFA) class if one is offered in your area. If there is not one close to you, encourage your local officials to get an MHFA training scheduled for your locale.

Teaching, while enjoyable takes a bit out of my time so the posts may come a little farther apart and the replies to your questions and comments will take a little longer but know that I values all your input and will get back to you all as quickly as I can.

Related articles
  • Are you a Functional Alcoholic? Do you know someone with an Alcohol Use Disorder? (counselorssoapbox.com)
  • How to control your drinking (counselorssoapbox.com)

    Staying connected with David Joel Miller

    Seven David Joel Miller Books are available now!

    My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

    Story Bureau.

    Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

    Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

    As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

    Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

    Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

    Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

    Planned Accidents  The second Arthur Mitchell and Plutus mystery.

    Letters from the Dead: The third in the Arthur Mitchell mystery series.

    What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

    Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

    For these and my upcoming books; please visit my Author Page – David Joel Miller

    Want the latest blog posts as they publish? Subscribe to this blog.

    For videos, see: Counselorssoapbox YouTube Video Channel

Why do so many substance users have mental illnesses?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs.

Drugs.
Photo courtesy of Pixabay.

Why are co-occurring disorders so common?

We used to talk about addiction and think there were just a handful of people with that problem; we blamed them for their disorder. We now know that long before someone becomes addicted they can have serious problems in their relationships with substances. We now are talking about substance use disorders.

We talked for a long time about the “seriously and persistently mentally ill” as if they were somehow different from us. We now know that mental illness is on a continuum. Those emotional problems, depression, anxiety, stress-related issues, can overwhelm anyone.

Is it really that common to have both problems?  Why do we say now that co-occurring disorders are an expectation, not an exception?”

So far in my career as a therapist, I have worked with substance abusers. I have worked in locked psychiatric hospitals with those on an involuntary hold for wanting to kill themselves or others. I have also been able to work with adolescents in crisis.

In every one of these settings, the number of clients who had both issues was large. Why do the two problems so often exist in the same person? Here are some of the reasons that both disorders so often co-exist in the same person.

1. Two issues, substance use disorders, and a mental or emotional illness are relatively common in our society.

Far short of addiction there are plenty of people who attend DUI School, lose days of work, or get into arguments with their spouses as a direct result of substance misuse.

Most families have one or more person in them who has been so depressed or so anxious that they missed work or stopped participating in family and social activities.

2. Having a mental or emotional problem increases the risk of using and abusing substances.

People who are depressed or anxious often start drinking. At first, this works but over time the alcohol makes them more depressed and when it wears off they become more anxious.

The result of using substances to manage your emotions is that over time you need more and more and eventually, you develop a substance use problem.

Many people in substance abuse treatment will report emotional problems including being the victim of abuse or neglect before they developed the substance abuse problems.

The seriously mentally ill find the effects of smoking very soothing. They become heavy smokers. This increases the risk that they will develop health problems, end up homeless, and that their lifespan will be cut short.

3. Using or abusing substances increases the risk of developing a Mental illness.

Alcohol is a depressant. Not everyone who drinks becomes clinically depressed but some people do. The more you drink the more depressed you become. The more depressed you get the more you drink. This can be a rapid downward spiral.

There are connections between many other abused substances and developing mental illnesses. Stimulants increase the risk of psychosis and can increase sexual behaviors. The younger you are when you begin to smoke Marijuana the more likely you are to develop certain mental health issues.

I am not trying to take sides here on the “medical marijuana” debate, but note that smoking anything, dried lettuce or incense included, is bad for the lungs. There is also a developing body of research that says that CBD is better for medicinal use and THC is not. If you are smoking marijuana to “get high” you are at risk to develop problems with its use no matter what story you are telling others. (I think I wrote some posts on that one, note to self-see if those articles got posted.)

4. Substance abuse issues or mental and emotional problems results in a lifestyle where it becomes hard to get your basic needs met.

Both groups have an increased risk of homelessness. They are both at risk to become alienated from family and friends.

You have to do what you have to do.

The result of these lifestyle changes is that the substance abuser is likely to become depressed, anxious, or to be abused. The mentally ill person, to cope with their isolation or homelessness, may turn to alcohol or drugs to cope.

What you go through with either problem increases the risk that you will develop the other disorder.

5. There are emotional consequences to entering recovery.

The substance abuser often gets closer to their drug of choice than to others in their life. When they stop using or abusing they have to go through a grieving process that can be just as severe as a divorce or death in the family.

Users have told me that “women come and go but crystal is always there for me.” People let me down but (fill in the name of liquor here) is always waiting for me. Losing this one support can be a major obstacle in creating a new life.

People in recovery very much need a new support system.

The conclusion?

Having either a substance use disorder, or a mental-emotional problem, increase the risk of having the other. It is easy to get locked in a pattern when no one is supporting your recovery and your environment is supporting you staying sick. Change can be difficult but change – recovery is very much worth the effort.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Top 10 Mental Health Blog posts of 2013

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Counselorssoapbox.com

Here are the most read mental health blog posts from 2013, at least the most read posts here on counselorssoapbox.com

With over 700 posts now available here on counselorssoapbox.com, a few continue to be read and reread each and every day.

In case you missed any of these Mental Health or Substance Abuse posts the links are below. There are also a whole parcel of other posts, some of them very specialized. You might want to look through the library of past posts or try the search feature to look for things that are of interest to you.

Many of the posts over the last year were inspired by questions that you readers sent in and the comments you left at the end of posts. Keep those comments and questions coming. It helps me to know what you would like me to talk about next.

Every question or comment deserves a reply and please know that I wish I could get back to you all right away but this schedule, having to work and trying to write does not always allow me to post responses as quickly as I would like. Just know that I really want to tell you things that are accurate and that means some time researching things and thinking about them before I post that reply.

The work on the book I have been writing is accelerating and I hope to have more to tell you on that topic in the near future.

Without further delay – the top Mental Health posts on counselorssoapbox.com for 2013 are:

1. How much should you tell a therapist?  

2. Levels or types of Borderline Personality Disorder 

3. Do therapists have to report a crime? 

4. Do people really forget what happened when drinking? – Blackouts   

5. Which border is Borderline Intellectual Functioning on? 

6. Are you Hyperthymic?

7. Hyperthymia, Hyperthymic Personality Disorder and Bipolar Disorder

8. Is nicotine a stimulant or a depressant?  

9. Why can’t we forget the painful past?

10. 6 ways to recover from Complex Trauma or Complex PTSD

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What does carrying a court card mean?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is a “Court Card” and where do you get one?

Alcoholics Anonymous (A.A. Meetings) and the court or treatment facilities are not related.

A. A. has a policy of declining outside money so that they can stay independent and focus on helping the next alcoholic.

So why do so many judges, courts, and rehab programs recommend that people go to A.A? And how do you get a form for the court telling the judge that you went to a meeting if everyone who attends is anonymous?

The simplest solution to this dilemma is the “court card.”

Some courts or probation departments have specific forms they want you to carry and have signed. Others will simply tell you to get a “court card” signed. Programs that require the client to turn in “meeting slips” may also have their own form they want people to use.

In these cases get the form from the person who told you to go to A.A., not from the A.A. meeting.

For practical purposes, most people use any small pieces of paper with their name at the top and a place for the secretary of the meeting to record the date, the name of the meeting, and a place for the secretary to sign.

A.A. meetings are all volunteer-run so they do not have offices, write letters and because of anonymity, they do not keep records of who attends. For those reasons make sure you are nice to the person you ask to sign your paper.

Also, remember to get the court card in before the meeting starts and pick it up after the meeting is over. Take care of your responsibility to get it signed.

Remember if you lose this one there is no going back and getting it signed later. Lose that “court card” and you get to do some more meetings and get a new card or paper signed.

The posts I write about A.A. are from my perspective as a therapist and clinical counselor and do not necessarily reflect the views of A.A. World Services. For more on A.A. and their program of recovery check out the “A.A. Big Book” titled Alcoholics Anonymous at the links below or contact A.A. World Services at their website.

The Big Book of Alcoholics Anonymous

The classic text on Alcoholism and recovery, this is the book that started off the whole 12 step phenomenon.

Alcoholics Anonymous from The Anonymous Press

One of the Kindle editions – At 99 cents this is such a bargain. This edition needed a separate listing. No Kindle reader? No Problem, if you have a computer you can download a free Kindle reader.

http://www.aa.org

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Is your lover an addiction?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Couple

Relationship.
Photo courtesy of Pixabay.com

When your lover is an addiction it is not a healthy relationship.

Human lovers may be with you for a lifetime or they can come and go – but that addiction is always there for you. Some people have love or sex addictions. They can’t stand the thought of being alone or not having a partner. They settle for a bad relationship in preference to being alone. They can’t seem to develop a healthy relationship with themselves.

If your lover is Gambling, alcohol, or drugs you know that your addiction will be waiting for you, demanding your devotion as human partners come and go.

The love of your life may be shopping or the go-in-debt-at-home channel. It may be hoarding useless things. Most any activity can become an addiction if you can’t stop thinking about it and eventually you lose control and have to do it one more time, whether you wanted to or not.

Clearly, drugs and their older sneakier cousin, Alcohol, win the contest for addictions that can take control of you.

Most people with addictions become closer to their addiction, often a drug of choice than to the humans in their life. Somehow we hold on to that love for that addiction even when it begins to treat us badly.

I have seen a number of people stuck in bad relationships with other humans. Eventually, most of them have had enough. They either come for counseling and try to change their relationship, or they decide to leave the other person. Occasionally someone hangs on even though they know that this is not a good relationship. They hang on because the prospect of letting go feels worse to them than the pain of staying.

It is even worse when the partner you are leaving is an addiction.

People who give up their addiction are letting go of their best friend, their lover, and their full-time life companion.

They tell me that partners come and go but that “Crystal” is always there for them. Women may reject you but “Sherry” is there in the bottle waiting for you. And your drug of choice, it always changes the way you feel. Until it begins abusing you.

Having had a long-term relationship with a drug of choice results in a lot of grief and loss issues when you finally decide to give her up.

While you are grieving over your lost partner, Whisky or Beer, wine or Meth, everywhere you go there are people trying to get you two back together again.

Your friends, they all know “Crystal” and “Sherry” and they tell you – have just one more for old-time sake. Even the stores are out to get you with their reminders of your lost love. The beer is stacked up by the door and the milk is at the end of the wine aisle.

Like any other lost love when you are trying to get over an addiction everywhere you go there are reminders.

Do not give up. Going back to an addiction is not a way to find happiness. Eventually, the grief will pass and you will find a new happier life waiting for you.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel